vHIT Atlas

An interactive teaching atlas of the video head impulse test

This atlas teaches the video head impulse test from first principles to bedside interpretation. Every chapter is layered into three reading levels — Foundation for newcomers, Trainee for residents and graduate students, and Clinician for practising specialists. Choose the level that fits, switch between them as you read, and use the embedded simulators to build pattern recognition.

Companion to the VEMP Atlas, this resource is intended for audiologists, otolaryngologists, neurologists, and vestibular physiotherapists. Nothing here replaces clinical training. Patient care decisions need an experienced clinician with access to the full history, examination, and the actual goggles in front of them.

Foundations

How the test works, what a normal trace looks like, and how to read saccades.

Chapter 1
Introduction
What vHIT is and where it fits
Chapter 2
Anatomy and physiology
Labyrinth, canals, hair cells, VOR arc
Chapter 3
Technique
Goggles, calibration, head impulses, pitfalls
Chapter 4
Normal traces
Expected gain by canal, age, and head velocity
Chapter 5
Saccades and VOR gain
Overt, covert, anti-compensatory, and how to grade
Chapter 6
HIMP vs SHIMP
Two paradigms, complementary information

Disease pages

Recognisable patterns across the common and important conditions.

Chapter 7
Vestibular neuritis
Acute superior and inferior vestibular nerve loss
Chapter 8
Meniere disease
Caloric–vHIT dissociation as a diagnostic marker
Chapter 9
Vestibular schwannoma
Slowly progressive unilateral vestibular loss
Chapter 10
BPPV
Positional vertigo with a normal vHIT
Chapter 11
Vestibular migraine
Episodic vestibulopathy with usually normal vHIT
Chapter 12
Bilateral vestibulopathy
Oscillopsia and bilateral high-frequency loss
Chapter 13
Central vHIT patterns
PICA, AICA, SCA strokes and the central mimics
Chapter 14
Ototoxicity
Aminoglycosides, platinum agents, monitoring strategies
Chapter 15
Post-surgical vHIT
Recovery after labyrinthectomy and schwannoma resection

Populations

How age and development change interpretation.

Chapter 16
Paediatric vHIT
Developmental gain values and modified protocols
Chapter 17
Age-related vestibular loss
Presbyvestibulopathy and ageing of the VOR

Acute syndrome and interpretation

Chapter 18
HINTS and acute vestibular syndrome
The bedside discriminator between neuritis and stroke
Chapter 19
Interpretation and reporting
Putting the trace, saccades, and context together

Tools

Simulators
Six interactive tools
Pattern trainer
Quiz yourself against 9 archetypes
Clinical cases
Diagnose 8 real-world scenarios
Self-assessment
Spaced repetition and timed modes
Glossary
38 terms with cross-references
References
Peer-reviewed citations
Progress
Track what you've learned
Print everything
Single-document export